As the world is in the throes of the COVID-19 pandemic, in South Asia, Afghanistan is especially vulnerable because it shares a 921-km open border with Iran. The Republic of Iran is one of the worst-affected nations in the world by the coronavirus.
As of today (March 28, 2020) Iran has registered 15,315 active cases of coronavirus with 2,234 persons dead, and counting. In Afghanistan, the number of coronavirus cases has seen a steady increase. Out of the approximately 800 suspected cases, there are now 110 positive cases and four deaths. With an epidemic at its borders, Afghanistan’s weakened public healthcare system faces its gravest challenge.
Thousands of Afghan refugees are returning from Iran every day in overloaded taxis, buses and minivans into the chaos of rudimentary health screenings at the border crossing. According to the International Organisation for Migration, more than 115,000 Afghans returned from Iran just between March 8 and 21. This marked the highest rate of returning immigrants from Iran in over a decade.
The Islam Qala-Dougharoun is the most-used border crossing point, connecting the cities of Herat, Afghanistan and Mashhad, Iran. According to the agency, even if the border crossing were to be closed, Afghans who wanted to get home could easily find a way, given how porous the border is.
Given this massive influx from one of the worst-affected countries in the world, the city of Herat, with nearly 300,000 people, has become the epicentre of the virus in Afghanistan. Till March 26, it had over 65 confirmed virus cases in Afghanistan. Kabul, with seven active cases, is the second most affected city.
The first casualty from COVID-19 in Afghanistan was reported from Balkh, thereafter three casualties were all from Herat. Four NATO members whose nationalities have been withheld have also tested positive for COVID-19 in Afghanistan. By March 26, the death toll from COVID-19 has gone up to four, with another 55-year-old man dying in Herat.
According to medical journal Lancet, the first case of COVID-19 in Afghanistan came from Iran. In early February a 35-year-old male Afghan shopkeeper visited Qom, Iran where he stayed for nearly a week and home to Herat on February 15, 2020. The very next day, he began to display the initial symptoms of COVID 19 – fever, headache, cough and dyspnea. At the private clinic which he visited for his initial checkup, he was suspected of having contracted COVID-19 as he had recently returned from Iran and he was referred to the governmental hospital for further investigation.
The confirmed diagnosis was made three days after admission. Seventeen days from admission, the patient was in good health and a molecular test was done again with a negative result. All individuals who had been in close contact with the patient were quarantined at home, and accommodations and vehicles related to the patient were disinfected.
One of the biggest challenges that healthcare givers are facing is the detection of COVID-19 in asymptomatic patients. In order to circumvent the substantial chains of transmission throughout Afghanistan, it is essential that a complete lockdown be enforced in the provinces bordering Iran. In Herat province, people have been disturbingly cavalier towards the spread of coronavirus, attending a buzkashi match, prayer meetings, visiting markets and celebrating during the Persian new year festival of Nowruz (March 21-22).
In a bid to curb the spread of the coronavirus, a new 100-bed hospital is being hurriedly built in Herat. In a country where health services can only be described as fragile, an unchecked community outbreak of coronavirus will mean that half of Afghanistan’s estimated 32 to 34 million people could contract the virus, and that more than 110,000 may die. Given this grave situation, on March 25, 2020 Afghan authorities locked down the western province of Herat bordering Iran. A curfew has now been imposed in the three provinces bordering Iran – Herat, Farah and Nimroz. And from today, a lockdown will be applied in Kabul and its provincial districts.
Amidst crippling sanctions, Iran is unable to access medical aid and equipment. Tehran has rejected the humanitarian assistance offered by Washington, and instead in a message directed at Washington Ayatollah Khameini charged, “No one trusts you. You are capable of bringing into our country a drug that will keep the virus alive and prevent its eradication.”
In response to Afghanistan’s and Iran’s cases, Pakistan closed its border at Chaman with Afghanistan, starting on March 2. Then on March 21, Pakistan reopened the Chaman-Spinboldak border. Apparently a decision taken on humanitarian grounds, there are apprehensions as Pakistan witnessed a rise in coronavirus cases after pilgrims from Iran entered the country via the Taftan border.
The number of confirmed coronavirus cases in Pakistan has jumped to 1,106. Reports indicate that the Pakistan army has started to move COVID-19 positive patients from Punjab province to Pakistan-occupied Kashmir (PoK) and Gilgit Baltistan. Locals in Muzaffarabad and Mirpur are protesting the setting up of quarantine centres in an area where there are hardly any healthcare facilities.
In this situation, India’s has played a decisive role in forming a joint strategy to fight COVID-19 in the SAARC region and initiating a ‘SAARC Corona Emergency Fund’ with a contribution of $10 million. India evacuated nearly 400 of its citizens from Iran between March 10 and 15. When Iran refused to screen Indians stranded in the country for coronavirus, India dispatched a temporary lab, medicines, doctors, healthcare workers and medical personnel to Iran for testing, screening the people for coronavirus, evacuating Indians and foreign nationals from there and later announcing to donate the lab to Iran.
For Afghanistan, which is in the midst of an internal dissension, with both Ashraf Ghani and Abdullah Abdullah claiming to be presidents, a violent Islamic State attack on the Sikh community, talks with the Taliban and withdrawal of $1 billion American aid, a mass outbreak of the virus would be cataclysmic.
The pandemic calls for a large-scale response. As the traditional security provider in the region, India must too be at forefront in the battle against COVID-19, by coordinating a platform to ensure sustained funding and delivery of diagnostics and treatments.
Vaishali Basu Sharma has worked as a consultant with the National Security Council Secretariat (NSCS) for several years. She is, at present, associated with the think tank Policy Perspectives Foundation.